DicomWorks: Software for Reviewing DICOM Studies and Promoting Low-cost Teleradiology

DicomWorks is freeware software for reading and working on medical images [digital imaging and communication in medicine (DICOM)]. It was jointly developed by two research laboratories, with the feedback of more than 35,000 registered users throughout the world who provided information to guide its development. We detail their occupations (50% radiologists, 20% engineers, 9% medical physicists, 7% cardiologists, 6% neurologists, and 8% others), geographic origins, and main interests in the software. The viewer’s interface is similar to that of a picture archiving and communication system viewing station. It provides basic but efficient tools for opening DICOM images and reviewing and exporting them to teaching files or digital presentations. E-mail, FTP, or DICOM protocols are supported for transmitting images through a local network or the Internet. Thanks to its wide compatibility, a localized (15 languages) and user-friendly interface, and its opened architecture, DicomWorks helps quick development of non proprietary, low-cost image review or teleradiology solutions in developed and emerging countries.     

The Current State of Teleradiology Across the United States: A National Survey of Radiologists’ Habits,Attitudes, and Perceptions on Teleradiology Practice

PurposeTo explore the current state of teleradiology practice, defined as the interpretation of imaging examinations at a different facility from where the examination was performed.MethodsA national survey addressing radiologists’ habits, attitudes, and perceptions regarding teleradiology was distributed by e-mail to a random sample of ACR members in early 2019.ResultsAmong 731 of 936 respondents who indicated a non-teleradiologist primary work setting, 85.6% reported performing teleradiology within the past 10 years and 25.4% reported that teleradiology represents a majority of their annual imaging volumes; 84.4% performed teleradiology for internal examinations and 45.7% for external examinations; 46.2% performed teleradiology for rural areas and 37.2% for critical access hospitals; 91.3% performed teleradiology during weekday normal business hours and 44.5% to 79.6% over evening, overnight, and weekend hours. In all, 76.9% to 86.2% perceived value from teleradiology for geographic, after-hours, and multispecialty coverage, as well as reduced interpretation turnaround times. The most common challenges for teleradiology were electronic health record access (62.8%), quality assurance (53.8%), and technologist proximity (48.4%). The strategy most commonly considered useful for improving teleradiology was technical interpretation standards (33.3%). Radiologists in smaller practices were less likely to perform teleradiology or performed teleradiology for lower fractions of work, were less likely to experience coverage advantages of teleradiology, and reported larger implementation challenges, particularly relating to electronic health records and prior examination access.ConclusionDespite historic concerns, teleradiology is widespread throughout modern radiology practice, helping practices achieve geographic, after-hours, and multispecialty coverage; reducing turnaround times; and expanding underserved access. Nonetheless, quality assurance of offsite examinations remains necessary. IT integration solutions could help smaller practices achieve teleradiology’s benefits.     

Teleradiology at the 121st General Hospital in Yongsan,Korea

Summary. The 121st General Hospital in the Yongsan district of Seoul. Korea provides teleradiology services for the US Armed Forces in South Korea. The operation of this teleradiology service is a model of the support of rural teleradiology, providing radiology services to outlying clinics over a large geographic area. In a typical week this hospital receives and processes 225 radiological exams or 45 exams per day from 13 outlying clinics. During military exercises the load can increase dramatically. The result of the teleradiology service is a sharp improvement in the radiology service at the outlying clinics and faster more effective care for the patients of those clinics.     

远程医学惠民工程网络架构与实现

根据山东省远程医学惠民工程的具体需求，利用计算机网络技术、视频影像技术、结合数字医疗设备，开发远程医学网络，实现了远程诊断、手术、护理、监护、医学信息、医学培训、病例研讨等功能。     

Home teleconsultations with faculty subspecialists on chest images from an intensive care unit

Study objective: To determine whether teleconsultations by first-year radiology residents with faculty thoracic radiologists, using diagnostic-quality teleradiology workstations in the radiologists' homes, would add clinical value for the acute management of intensive care unit patients after regular working hours. Design and setting: First-year radiology residents recorded key findings on new computed chest radiographs from 173 cardiothoracic intensive care unit patients. After consulting with home-based thoracic radiologists on the same images via teleradiology, they recorded any revisions to their original interpretations. An interdisciplinary evaluation panel determined whether the revisions of the residents' initial readings after the teleradiology consultations would have influenced the acute clinical care of these patients. Measurements and results: In 119 of the 173 cases (69 %), differences in key findings on the chest images were observed between the first-year residents' preliminary readings and their revised readings after teleconsultation with a thoracic radiologist. The evaluation panel determined that the changes in key findings after the teleconsultations could have influenced acute patient care in 86 of the 173 cases (50 %). Conclusions: Through rapid teleradiology consultations with residents, focusing on the key findings on newly-obtained computed chest images, home-based thoracic radiologists provided information of added clinical value for the acute management of cardiothoracic intensive care unit patients in one-half of the cases studied. Diagnostic workstations in the homes of faculty subspecialists may enable first-year radiology residents on night or weekend duty to obtain clinical supervision from faculty subspecialists that approximates more closely the level of supervision that they receive during regular working hours.     

DICOM-E-Mail在我国实现的设想

结合了国内的实际情况，提出了DICOM-E-Mail在国内进行临床应用的策略和方案。     

影像会诊系统建设的核心需求分析

针对远程会诊中影像会诊系统的建设情况,对影像会诊系统与相关信息系统的关系、核心功能、系统内数据组织形式进行了需求分析,以达到规划建设一个高效、方便的影像会诊系统的目标.     

Uses and benefits of telemedicine

Summary. The true benefits of telemedicine are yet to be realized. The reasons are linked to business, economic and operational issues, not technology application. Telemedicine is an application of specific technologies designed to fill a health care delivery need, while expanding the geographic footprint of the overall delivery systems. It offers the opportunity for competitive advantage in a dynamic industry through improved quality, expanded care delivery and reduced cost. Telemedicine's true impact on the care delivery process will be fully realized once these opportunities have been optimized within a health care system.